Mood Disorders Flashcards
1
Q
Biopsychosocial Model
A
- Biological, social, and psychological factors interact to create a problem, lack of problem, or strength in a person
- Not a core reason for mental health issues
2
Q
DSM5
A
- Current edition
- released in 2013
- controversial due to:
- lower thresholds
- poor empirical justifications for some inclusions/exclusions/changes
- introduced some dimensional classifications
- reliability has improved
- some diagnoses have consistently poor reliability
3
Q
DSM5 organization of mood disorders
A
- Depressive Disorders
- Major depressive disorder
- persistent depressive disorder
- seasonal affective disorder
- premenstrual dysphoric disorder
- disruptive mood regulation disorder
- due to substance or GMC
- Bipolar and related disorders
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
4
Q
Criteria for Major Depressive Disorder
A
- Aka Major Depressive Episodes
- Has to meet 5 of the 9 symptoms for 2 week period
- 1 of them has to be either:
- depressed mood (1)
- Anhendonia-loss of interest or pleasure (2)
- Symptoms after the first 2 can be associated to anything
- 1 of them has to be either:
- No maniac episode
- not just simple bereavement
- not a grieving process
- Severity
- Remission Status
- other features:
- psychotic
- melancholic
- atypical
- anxious distress
5
Q
Major Depressive Disorder Subtypes
A
- Anxious distress
- Mixed features
- Melancholic features
- Psychotic Features
- Catatonic Features
- Atypical Features
- Seasonal Pattern
- Peripartum onset
Don’t always use in diagnoses, but it allows us to communicate diagnosis to other professional.
- especially what kind of symptoms patient is experiencing
6
Q
Course of Depression
A
It can vary
- Progression in reduction of mood
- Onset of depressive symptoms
- Treatment: Acute phase
- Response/Improvement
- Relapse
- Symptoms return
- Treatment: Maintenance Phase
- remission
- recovery
- Treatment: Acute phase
7
Q
Demographics of Major Depressive Disorder
A
- Demographics for lifetime prevalence
- Sex: Women 50% more likely to experience a mood disorder over lifetime
- Race:
- Non-Hispanic blacks are 40% less likely
- Hispanics-20% less likely
- than non-Hispanic whites to experience a mood disorder during their lifetime
8
Q
Prevalence of Major Depressive Disorder
A
- 12 Month Prevalance
- 6-10%
- Lifetime prevalence
- 16%
- High susceptibility in young adults (18-29)
- Low among adults over Age 65 and is difficult to diagnose:
- less willing to report symptoms
- Symptoms occur in the context of a serious medical illness
- People with a history of depression are more likely to die before reaching old age
- Rates rise in >85 y.o.
9
Q
Persistent Depressive Disorder
A
- Aka Dysthymia & Chronic MDD
- Depressed mood for most of the day for at least 2 years
- Not a less severe form
- Risk for comorbid conditions are higher
- Prevalence: 2%
10
Q
Premenstrual dysphoric Disoder
A
- Increase in distress during the premenstrual phase
- due to extra-normative hormonal changes, significant distress or impairment
11
Q
Disruptive Mood dysregulation disorder
A
- Severe temper tantrums
- out of proportion in intensity and duration to a situation
- inconsistent with developmental level
- diagnosis for children 6 and older
- created to reduced bipolar diagnosis
12
Q
Biological Factors in Depression/MDD
A
- Genetic factors
- 1st degree relatives 2-3x more likely
- High concordance for mono- vs dizygotic twins
- identical vs fraternal twins
- Early life depression=stronger genetic basis
- Neurotransmitter Factors:
- norepinephrine
- serotonin
- dopamine
- Sleep dysregulation
- Neuroendocrine dysregulation
- HPA (Hypothalmaic pituitary adrenal) hyperactiivyt or hyperreactivity
- people who react very strongly to stress are more susceptible
13
Q
Psychological Factors
A
- Learned Helplessness
- Low rate of:
- positive reinforcement from the enviroment
- value-driven behavior
- Cognitive errors
- Persistent negative thinking patterns
- Poor social support
14
Q
Social Factors in Depression
A
- Poverty
- Margnialized Group=experience few advantages and are treated poorly in social contexts
- race
- sexual orientation
- etc.
15
Q
Treatment for Depression/MDD
A
- Antidepressant medications
- Tricyclics
- Monoamine oxidase inhibitors
- Selective Serotonin Reuptake Inhibitors (SSRI’s)
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRI’s)
- Other Somatic Therapies
- Electroconvulsive therapy
- Repetitive Transcranial Magnetic Stimulation (rTMS)
- Light Therapy
- Depp brain stimulation and Vagus Nerve Stimulation
- Side-effects are a major drawback to all biological treatment approaches
- Psychotherapy
- Cognitive Behavioral Therapy
- Behavior Therapyp (e.g. Behavioral Activation)
- Acceptance and Commitment Therapy
- most successful therapies are Theo nes that help the patient to change the way they think and/or way the live to facilitate mood
